# CHC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184028797
- **Authorized official:** DR. MALIA JOHNSON DDS (CLINIC DIRECTOR)
- **Authorized official phone:** (805) 929-3254

## Contact information

- **Practice address:** 150 TEJAS PL, NIPOMO, CA 93444-9123
- **Practice address phone:** (805) 929-3254
- **Mailing address:** 1120 CALLE ATAPANEO, NIPOMO, CA 93444-7807
- **Mailing address phone:** (805) 801-7883

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 63651 | CA | Yes |

## Other

- **Enumeration date:** 10/11/2014
- **Last updated:** 10/11/2014